Three‐dimensional Reconstruction of Non‐hodgkin's Lymphoma in Bone Marrow Trephines

Salisbury, Jon; Deverell, Mark H.; SEATON, JANE M.; Cookson, M. J.

doi:10.1002/(sici)1096-9896(199704)181:4<451::aid-path784>3.3.co;2-q

Cited by 7 publications

(8 citation statements)

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“…In HIV-positive patients, we noted many previously described features including increased size, poorly circumscribed margins, and a lymphohistiocytic pattern with no distinct granuloma formation [9,[28][29][30]. Moreover, the loss of benign aggregates in deeper sections, an observation made by Salisbury et al [15,16], was also a prominent feature in our study.…”

Section: Discussionsupporting

confidence: 82%

“…BLAs are typically small (b600 μm), are relatively uniform in size, have a distinct border, and have a nonparatrabecular location [1,2,9]. Although exact measurements of lymphoid aggregates are typically not conducted, BLAs are more likely to be lost in deeper sections, as seen in 14 of our cases, or become smaller as seen in many of our cases, whereas larger lymphomatous aggregates are more likely to remain in deeper sections [15,16]. Among our 40 lymphoma cases used for comparison purposes and in cases that contained aggregates suspicious for lymphoma, the aggregates not only persisted, but in some cases, their paratrabecular location became more evident.…”

Section: Discussionmentioning

confidence: 82%

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Benign lymphoid aggregates in the bone marrow: distribution patterns of B and T lymphocytes

et al. 2013

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Summary Benign lymphoid aggregates are seen in only a minority of bone marrow specimens, but their distinction from non-Hodgkin lymphoma, particularly B-cell lymphomas, can represent a diagnostic challenge. Although criteria have been proposed to help distinguish between benign and malignant aggregates, a detailed description of the distribution patterns of B and T lymphocytes within benign lymphoid aggregates has not been investigated. One hundred thirty-seven cases of bone marrow specimens containing benign aggregates were studied with a panel of immunostains. A subset of these cases was also examined for immunoglobulin gene rearrangements by polymerase chain reaction. The aggregates were categorized based on size, location (paratrabecular or random), presence of infiltrating edges, and distribution of lymphoid cell populations. In addition, we examined 40 cases of bone marrow biopsies with documented malignant lymphoid aggregates for comparison purposes. We report that the distribution of B and T lymphocytes within lymphoid aggregates may serve as a useful criterion to aid in the separation between benign and malignant aggregates. When aggregates exhibit a predominance of T cells, consist of a central core of T cells surrounded by a rim of B cells, or have a mixed distribution of B and T cells, they are more likely to be benign. On the other hand, an increased likelihood of malignancy occurs when aggregates exhibit a predominance of B cells or consist of a central core of B cells surrounded by a rim of T cells (excluding germinal center formation), and assessing other features worrisome of malignancy (large aggregate size, presence of infiltrative edges, cellular atypia, and paratrabecular location, among others) is warranted.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 82%

Benign lymphoid aggregates in the bone marrow: distribution patterns of B and T lymphocytes

et al. 2013

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“…5 Spaces appear round to ovoid in shape. One of them is very close to a lymphatic vessel (positive for D2-40) present in the perilobular stroma reconstruction of normal structures and of specific lesions from the analysis of multiple histological sections (static 3D) has proven to be a valuable technique in different areas of pathology such as normal distribution of microcirculation of retina [14], para-trabecular pattern of infiltration of nonHodgkin's lymphoma in bone marrow [15], angiogenesis in the bone marrow of children with leukemia [16], distribution of microvessels in prostate cancer [17], evaluation and reconstruction of spinal cord injury [18], relationship between functional and structural changes of glomerular capillary networks in normal kidney [19], distribution and organisation of microvascular structure of cardiac coronary vascular tree [20], distribution of the vessels in normal and neoplastic thyroid [10] and distributions of vessels in oligodendrogliomas [21]. In breast, Ohtake et al [22,23], in a 3D reconstruction of intraductal extension of invasive breast carcinoma, have highlighted the presence of occasional intralobar and extralobar anastomoses which allowed the spread of in situ duct carcinoma through different lobes.…”

Section: Discussionmentioning

confidence: 99%

The pre-lymphatic pathway, the rooths of the lymphatic system in breast tissue: a 3D study

et al. 2008

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Three-dimensional (3D) visualisation of microscopic structures provides useful information about their configuration and the spatial (hence functional) relationship between different components in tissues. This paper describes 3D dynamic reconstructions of the pre-lymphatic labyrinth in two cases of "normal" breast core biopsies and one case of pseudoangiomatous stromal hyperplasia. Direct anastomoses between pre-lymphatic channels and true lymphatics of the breast were demonstrated. It is concluded that pre-lymphatics are a way of communication between breast epithelial/stromal structures and the main lymphatic system. The present findings suggest that the existence of pre-lymphatics has to be taken in consideration in the intramammary spread of malignant tumours.

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“…T-NHL are rare diseases accounting for approximately 15% of all lymphoproliferative disorders in the Western world, with peripheral T-cell lymphoma (PTCL) unspecified, angioimmunoblastic T-cell lymphoma (AITL), cutaneous T-cell lymphomas, and anaplastic large-cell lymphoma (ALCL) representing the most common entities [129]. The frequency and the histology of BM involvement vary greatly between the different entities.…”

Section: General Considerationsmentioning

confidence: 99%

Immunohistochemistry in bone marrow pathology: a useful adjunct for morphologic diagnosis

Kremer

Quintanilla-Martı́nez

Nährig

et al. 2005

Virchows Arch

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Pathomorphological examination of trephine biopsies of the bone marrow (BM) represents a standard method for the diagnosis and staging of hematologic neoplasms and other disorders involving the BM. The increasing knowledge about the genetic basis and biology of hematologic neoplasms, as well as the recently proposed WHO classification system, provide the framework for an accurate diagnosis. Although conventional morphology remains the gold standard for paraffin-embedded BM trephines, immunohistochemical stainings have become an integral part of the diagnostic workup. Antibodies suitable for paraffin sections are generally applicable to BM trephines, but modifications of staining protocols may be necessary due to the alternative fixatives and decalcification procedures used for BM biopsies. The indications for immunostainings range from confirmation and classification of lymphoma involvement, subclassification of acute leukemias, and estimating blast counts in myelodysplastic and myeloproliferative syndromes to characterization of BM involvement in nonhematologic neoplasms. Although subtyping of NHL in the BM is more difficult from the point of morphology, classification of the entities that frequently involve the BM, especially the small B-cell lymphomas, can easily be achieved with the help of immunohistochemistry. In this review, we try to summarize the current state of the art in BM immunohistochemistry for the diagnosis of hematologic disorders. Moreover, diagnostic algorithms and useful antibody panels are proposed for a rational and cost-effective approach.

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Three‐dimensional Reconstruction of Non‐hodgkin's Lymphoma in Bone Marrow Trephines

Cited by 7 publications

References 0 publications

Benign lymphoid aggregates in the bone marrow: distribution patterns of B and T lymphocytes

Benign lymphoid aggregates in the bone marrow: distribution patterns of B and T lymphocytes

The pre-lymphatic pathway, the rooths of the lymphatic system in breast tissue: a 3D study

Immunohistochemistry in bone marrow pathology: a useful adjunct for morphologic diagnosis

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